Cultural insights enhance access to breast cancer care

Many women who develop breast cancer in low-income countries, like Bangladesh, die having never even sought medical care.

“The vast majority of cancer deaths occur in low and middle income countries, and about a third of these deaths could be prevented,” says Dr. Ophira Ginsburg.

“It’s not just a resource issue,” says Ginsburg. “Bangladeshis view breast cancer as a curse and a certain death sentence, so a woman who seeks treatment places herself at risk.”

Ginsburg and her partners are training Bangladeshi women to be community health workers, tasked with educating their peers about breast health. Supported by Grand Challenges Canada, the pilot project is harnessing mobile technology to track and refer patients for care at a breast clinic that Ginsburg co-founded in partnership with the International Breast Cancer Research Foundation and a local NGO, Amader Gram.

Designed to be both affordable and sustainable, the project is building capacity in Bangladesh. It’s also establishing a new model of care that may improve outcomes for a wide range of non-communicable diseases in Bangladesh and other low-income countries.

The socio-cultural barriers that discourage Bangladeshi women from seeking breast care can also have an impact in Canada.

“These attitudes follow immigrants when they arrive in Canada, making this population particularly vulnerable to undiagnosed breast disease, and likely to other illnesses as well,” Ginsburg says.

To address barriers to care in Canada, Ginsburg is studying factors that influence whether immigrant Bangladeshi women seek breast treatments in their new country. Working with Dr. Farah Ahmad (York University) and Toronto’s Thorncliffe Neighbourhood Office (Crescent Town Club), she hopes that her work will inform programs that encourage more women to seek breast care.

“We need to understand how women are making decisions to seek care, so that we can create the most effective targeted interventions.”

Dr. Ophira Ginsburg is a scientist at WCRI and a University of Toronto assistant professor in the Dalla Lana School of Public Health and the Department of Medicine. Ginsburg’s work in Bangladesh is supported by Grand Challenges Canada’s Rising Stars in Global Health Award. It’s the second year in a row that a Women’s College scientist has won. Last year, a WCRI post-doctoral fellow Dr. Carmen Logie received the same award. Today, Logie’s award is supporting her innovative program in Haiti, which gives local women training and solar-powered tablets to teach their peers about HIV prevention.